Revascularization is an interventional procedure for the provision of a new, additional, or augmented blood supply to a body part or organ. Revascularization typically involves a thorough analysis and/or diagnosis and treatment of the existing diseased vasculature of the affected organ. In some instances, revascularization can be aided by the use of different imaging modalities, such as magnetic resonance imaging (MRI), positron emission tomography (PET) scan, computed tomography (CT) scan, and X ray fluoroscopy.
Revascularization is designed to improve blood flow to tissues perfused by the principal arterial vessel(s) supplying that tissue. Revascularization may be needed, for example, due to an obstruction in the native arterial vessel supplying that tissue. Coronary artery bypass grafting (CABG) is a revascularization procedure that may be used to increase blood flow to ischemic myocardium by bypassing the native coronary obstructions.
There are two measurement components to the revascularization evaluation, blood flow in the principal arterial supply and quantitative perfusion in the tissue. Conventional methods for measurement of blood flow and perfusion are limited, despite the benefit these measurements would bring to the clinical evaluation of the quality of the revascularization procedure.
Some conventional interoperative methods of measuring blood flow are based on ultrasound detection of blood flow in the graft conduits, but not the native principal arterial vessel(s). Some conventional angiographic evaluation methods include conventional coronary angiography performed in a hybrid operating room setting at the time of surgery. Recently, Novadaq Technologies, Inc. of Toronto, Canada has introduced fluorescence imaging that uses both angiographic image evaluation and quantitative perfusion evaluation to CABG.
However, ultrasound detection typically requires physical contact between the graft vessel and a probe. Furthermore, ultrasound detection typically relies on proper placement of the probe around the vessel to obtain accurate measurement of flow speed and can be unreliable, measurement to measurement.
Coronary angiography typically requires radiation and administration of toxic image contrast agent. Furthermore, hybrid operating rooms used for coronary angiography can be relatively expensive, making this method unavailable to many patients undergoing CABG.
Fluorescence imaging typically requires injection of non-toxic dye into the patient. Furthermore, fluorescence imaging typically cannot provide information to directly determine the speed of blood flow in principal vessels. Despite the above, there remains a need for alternative methods of determining blood flow.